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What Causes Urinary Tract Infections Among Older Adults?

What causes urinary tract infections (UTIs), and why are they so common among older adults?

Expert Answers

Dr. Leslie Kernisan is the author of a popular blog and podcast at BetterHealthWhileAging.net. She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

Older adults are prone to urinary tract infections (UTIs) because they tend to experience certain problems that set people up for this kind of infection. Experts estimate that 25 to 30 percent of all infections in older adults are UTIs.

The root cause of urinary tract infections is usually bacteria growing in the urine within the bladder; unlike the bowels, the bladder is supposed to be a sterile environment. Bacteria grow in the urine of the bladder when one has difficulty emptying the bladder -- a common scenario for older adults. If the bladder isn't emptied completely, urine remains there longer than normal and bacteria have more time to start growing.

Other reasons that older adults develop urinary tract infections include the following:

They tend to have generally impaired immunity, especially if they're frail.

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Older men are more likely to have incomplete bladder draining due to prostate problems.

Postmenopausal women are more likely to have incomplete bladder draining due to bladder prolapse (when the bladder slips out of place) or cystocele (bulging of the bladder into the vagina).

Older people may retain urine due to anticholinergic medications (antihistamines, tricyclic antidepressants).

They're more likely to have bladder or bowel incontinence, which can lead to increased chances of contamination of the urethra (the canal through which urine exits the bladder).

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They're more apt to get an indwelling catheter while hospitalized or in a nursing home.

Note: Both older men and older women are prone to UTIs. This is different among younger and middle-aged adults: in that age group, UTIs are much more common in women. That's because the pathway into a woman's bladder (the urethra) is short, so it's relatively easy for bacteria to get to the bladder. Both sexual activity and use of spermicides have also been linked to UTIs.

Community Answers

Jpreaves answered...

Is there another, with symptoms mirroring the Bladder infection, infection similar and if so would the same antibiotic cure it?

This just happened to my wife who when diagnosed by the doctor thought it was bladder infection...however after sending it in to the Lab it came back saying it wasn't bladder infection........he told us to go ahead and take the antibiotic he has prescribed...that it would take care of it.

My question is......what other infection would mimic this?

Thanks,
Jean-Paul

Susanpe answered...

My mother is 85 years old and has alzheimers. Her previous caretaker let her wipe herself in the bathroom. Because she was not capable of understanding how to wipe herself properly (front to back), she got bladder infections a lot, one time it almost killed her as she became septic from the infection. She is now living with me. I do not let her wipe herself anymore, and she has not gotten an infection since.
Just to let you know, when an alzheimers patient has an infection and is pain, they do not have the capability, in most cases, to tell you. You must look for other symptoms, such as worsening confusion, agitation, increase in urge to urinate, but nothing hardly comes out....anything that is out of the ordinary of their behavior. It is critical that you take these symptom changes seriously, and get them to a doctor. I know from experience with my mother when we almost lost her. With the elderly, it can turn serious very fast. I hope this helps you.

Yvonne crump answered...

I was told by my old Doctor years ago to sqaut stand AFTER you have finished urunating then begin again. This empties the bowl properly. I had sufferred with lots of UTIs and after this procedure they all ended. I realize this will be hard for old and Alz patients to tip forward, maybe the commode could be angled slightly with the patient strapped in.

Grandmad answered...

My Mother really struggles with this she is 86 and has dementia... I think one of the issues we have is that she is fixated on NOT being incontinent, so she doesn't drink very well. We have done some tests and she does not have a prolapsed bladder. We have tried various meds (Detrol, Macrobid, Toviaz ) then she complains of not feeling well, being really tired and just wanting to sleep. I have tried EVERYTHING to get her to drink more... She takes two sips and is done...

Thehomestead answered...

grandmad we have a similar problem with MIL. She hardly drinks ANYTHING! She drinks water with her morning pills, half a cup of coffee, half a glass of milk at lunch and dinner. In all, she's not taking in more than 16 oz of fluids and REFUSES to drink any more. We too have tried everything. Wish I had an answer for you and me both.

Ellerysir answered...

My wife is prone to UTIs, doesn't know to wipe herself and is combative when touched. I keep a supply of fresh washcloths near the sink, soak one warm water, reach between her legs from behind, grab a corner, suspend the other corner at a height in front, and pull it through the back and up, thereby wiping front to back. Second cloth, I try to force outside vulva into groin. I may use several cloths if I see residue. I am careful of the applied pressure and experimented on myself first.
My wife will not drink, but she loves watermelon and I give her oatmeal morning and evening, soupy, made with 8oz of water.
Many meals are soup loaded with chunky vegetables.
Years of UTI's, antibiotics, some never worked, others over a long wait. Cyproflaxin cures on 1 dose in a day if oral, relief is 1 hour if via IV administered at ER. We have chosen ER last 2 times for her to not have a day of suffering.

Ellerysir answered...

On the question if something mimics bladder infection, I don't know but in the past 4 years, the labs were wrong twice. I monitor my wife's urine with 10 function urinalysis strips that I purchase from Amazon.com.
My wife can not reason or communicate, but she is very agile and active. We can tell when she has a UTI by her demeanor. Once in 2012, then in 2014, the strip said UTI, the lab said not. Double checked with strip, said yes. Different doctor, different lab verified.
Strips are also good to monitor hydration. Often we think she is not drinking enough, but she pees a lot and the strip verifies.
I periodically check strip accuracy against my own urine.

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